Wender Utah Rating Scale Research Articles

Does Temperament Constitute a Risk Factor for Adult Attention Deficit Hyperactivity Disorder?

The aim of this study was to examine the temperament characteristics of adults with attention deficit hyperactivity disorder (ADHD) and the relationship between ADHD subtypes and temperament. Additionally, the study aimed to investigate the relationship between childhood ADHD symptoms and temperament. The study included 59 ADHD patients aged between 18 and 60 years and 44 healthy controls. All participants completed the Wender-Utah Rating Scale (WURS) and the Adult Attention Deficit Hyperactivity Disorder Diagnosis and Rating Scale. Temperament characteristics were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire scale (TEMPS-A). The ADHD group had significantly higher scores for cyclothymic, irritable, and anxious temperament compared to the control group (p<0.001). The number of individuals with cyclothymic, irritable, and anxious temperament was also significantly higher in the ADHD group (p=0.007, p=0.018, p=0.029, respectively). Positive correlations were found between cyclothymic and depressive temperament scores and WURS scores (r=0.278, p=0.033; r=0.326, p=0.012, respectively), between hyperthymic temperament scores and hyperactivity scores (r=0.399, p=0.002), and between depressive temperament scores and attention deficit scores (r=0.303, p=0.020). There was no relationship between ADHD subtypes and dominant temperament (p>0.05). The most common dominant temperament in the ADHD group was cyclothymic, irritable, and anxious. The positive correlation between WURS scores and cyclothymic temperament suggests that cyclothymic temperament may be a risk factor for adult ADHD.

Using polygenic scores in combination with symptom rating scales to identify attention-deficit/hyperactivity disorder

BackgroundThe inclusion of biomarkers could improve diagnostic accuracy of attention-deficit/hyperactivity disorder (ADHD). One potential biomarker is the ADHD polygenic score (PGS), a measure of genetic liability for ADHD. This study aimed to investigate if the ADHD PGS can provide additional information alongside ADHD rating scales and examination of family history of ADHD to distinguish between ADHD cases and controls.MethodsPolygenic scores were calculated for 576 adults with ADHD and 530 ethnically matched controls. ADHD PGS was used alongside scores from the Wender-Utah Rating Scale (WURS) and the Adult ADHD Self-Report Scale (ASRS) as predictors of ADHD diagnosis in a set of nested logistic regression models. These models were compared by likelihood ratio (LR) tests, Akaike information criterion corrected for small samples (AICc), and Lee R². These analyses were repeated with family history of ADHD as a covariate in all models.ResultsThe ADHD PGS increased the variance explained of the ASRS by 0.58% points (pp) (R2ASRS = 61.11%, R2ASRS + PGS=61.69%), the WURS by 0.61pp (R2WURS = 77.33%, R2WURS + PGS= 77.94%), of ASRS and WURS together by 0.57pp (R2ASRS + WURS=80.84%, R2ASRS + WURS+PGS=81.40%), and of self-reported family history by 1.40pp (R2family = 28.06%, R2family + PGS=29.46%). These increases were statistically significant, as measured by LR tests and AICc.ConclusionWe found that the ADHD PGS contributed additional information to common diagnostic aids. However, the increase in variance explained was small, suggesting that the ADHD PGS is currently not a clinically useful diagnostic aid. Future studies should examine the utility of ADHD PGS in ADHD prediction alongside non-genetic risk factors, and the diagnostic utility of the ADHD PGS should be evaluated as more genetic data is accumulated and computational tools are further refined.

Attention Deficit Hyperactivity Disorder: A Risk Factor for Premature Discontinuation of Inpatient Opioid Withdrawal Treatment.

Background: Substance use disorders present a tremendous challenge within contemporary healthcare systems. Specifically, in the domain of opioid use disorders (OUDs), several foundational elements are crucial for the efficacious management of afflicted individuals. Regrettably, the premature discontinuation of inpatient opioid withdrawal treatment is a prevalent phenomenon. This study aims to elucidate the prevalence of the premature termination of inpatient opioid withdrawal treatment among patients with comorbid ADHD. Methods: We conducted a comprehensive assessment of all participants currently undergoing inpatient opioid withdrawal treatment. Our assessment protocol included the administration of the ADHD Self-Report Scale (ADHD-SR) and the Wender Utah Rating Scale (WURS-k). Additionally, participants who met the thresholds on one or both questionnaires underwent further evaluation using the Diagnostic Interview for ADHD in Adults (DIVA-2.0). Results: The prevalence of individuals diagnosed with ADHD within the studied cohort was determined to be 29.3%. Among the subset of participants identified as ADHD-positive, a notable 54.5% prematurely ceased therapy. In contrast, among those identified as ADHD-negative, the premature discontinuation rate was substantially lower at 28.3%. Conclusions: In summary, the impact of ADHD as a comorbid condition on the efficacy of inpatient opioid withdrawal treatment has been underscored. By identifying comorbid ADHD early in the treatment process, tailored therapeutic approaches may help to maximize the effectiveness of interventions and may improve patient outcomes. This underscores the importance of proactive screening for ADHD as a psychiatric comorbidity in optimizing the management of individuals undergoing inpatient opioid withdrawal treatment.

The WHO Adult ADHD self-report Scale used in a clinical sample of patients with overlapping symptoms - psychometric properties of and scoring methods for the Swedish translation

Background The WHO Adult ADHD Self-report Scale (ASRSv1.1 and ASRS-S) is used for screening for attention-deficit/hyperactivity disorder (ADHD). The capacity of the Swedish version of the scale to discriminate ADHD from borderline personality disorder (BPD) and bipolar disorder (BP) has not been tested. Aim Evaluate scoring methods, psychometric properties, and diagnostic accuracy of the Swedish versions of ASRSv1.1/ASRS-S in a group of patients with ADHD and/or BPD and/or BP. Method A total of 151 young adult psychiatric patients diagnosed with ADHD, BPD and/or BD completed ASRSv1.1 and the Wender Utah Rating Scale (WURS) for ADHD symptoms, and the Sheehan Disability Scale (SDS) for functional impairment. ADHD diagnoses were assessed with the Schedule for Affective Disorders and Schizophrenia (K-SADS) interview. Both versions of the scale were analysed through dichotomised and non-dichotomised scoring for diagnostic accuracy analysis. Results The internal consistency for ASRSv1.1/ASRS-S was satisfactory with α 0.913 and 0.743, respectively. The two-factor structure of the ASRSv1.1 and the one factor structure of ASRS-S were supported by the confirmatory factor analyses. A strong positive correlation was found between ASRSv1.1 and WURS and a moderate level of correlation was found between ASRSv1.1 and SDS. The area under the curve for both scoring methods were excellent with an area under the curve (AUC) of 0.808 and 0.817, respectively. Optimal cut-off scores were in line with the original recommendations. Conclusion The Swedish translation of ASRSv1.1/ASRS-S has psychometric properties comparable to other populations and the capacity to screen for ADHD in patients with overlapping symptoms.

Towards an increased attention on ADHD symptoms and traits in young adults: prevalence data from screening tools in a psychiatric outpatient clinic

IntroductionAttention–Deficit/Hyperactivity Disorder (ADHD) is a heterogeneous neurodevelopmental disorder encompassing developmentally inappropriate inattentiveness, hyperactivity, and increased impulsivity (DSM-5). Symptoms presentation is different for different stages of life; moreover, individuals with ADHD symptomatology can develop abilities and strategies that help them adapt and mask the distinctive features of the condition, thus reducing the functional impairment usually seen in ADHD subjects, and ultimately not receiving neither a clinical diagnosis nor a proper therapeutic support. They might express their lack of well-being through other transdiagnostic symptoms, and finally reach psychiatric attention for potential comorbidities. Hence, it was argued that the existence of children and adolescents with subthreshold and underrecognized symptoms that subsequently develop into a full diagnosis suggests that ADHD should be significantly more considered in adult mental health settings.ObjectivesHere we aimed to analyse the prevalence of ADHD symptoms and traits in a heterogeneous clinical psychiatric sample of young adults (aged 18 to 24 years old), who referred to a specialized outpatient clinic for various psychiatric and psychological disturbances.Methods259 participants completed three validated self-report screening questionnaires for ADHD: the Wender Utah Rating Scale (WURS), the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5 (ASRS-5), and the Conners’ adult ADHD rating scale (CAARS).Results12.4% of our sample scored above the cut-off at both the WURS and the ASRS-5 and was considered at risk of ADHD.Conclusions The prevalence rate in our sample is higher than the one found in the adult general population (6.76%), and in the lower range of the one found in the adult clinical population (6.9% to 38.8%). We discuss the potential role of sociodemographics (age, sex, gender identity, and employment) and comorbidity factors. Differences in the clinical presentation of ADHD according to sex assigned at birth and age should be considered during every psychiatric evaluation to minimize the risk of underdiagnosis. We advocate for further studies investigating the prevalence of ADHD in different psychiatric services for adults, and for a stronger presence of specialistic ADHD services and trained clinicians on the territory: this would increase diagnostic reliability, consequently providing a better treatment for ADHD in adults, and facilitate the transition from pediatric to adult’s services.Disclosure of InterestNone Declared

Substance use disorders in adults with attention-deficit/hyperactivity disorder: The role of affective temperament

ObjectiveSubstance Use Disorders (SUD) are common in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). Although predictors of SUD in this population are relevant for prevention and treatment, they need further clarification. Affective temperaments potentially associated with SUD in adult ADHD patients were explored. MethodsADHD patients with and without SUD were compared for sociodemographic, clinical, and psychological characteristics through: Adult ADHD Self-Report Scale; Wender Utah Rating Scale; Temperament Evaluation Memphis for Pisa, Paris, and San Diego-Autoquestionnaire. Logistic regression investigated factors associated with SUD. ResultsWe included one-hundred and thirty-six ADHD patients with (n = 51, 37.5 %) and without SUD (n = 85, 62.5 %). The presence of SUD was associated with irritable temperament (p = 0.009), as well as more frequent school failure (p = 0.038), legal problems (p = 0.039), and lifetime suicide attempts (p = 0.014). LimitationsThe cross-sectional design, the relatively small sample size, and the use of self-administered questionnaires. ConclusionsThis study confirms the greater overall severity of adult ADHD-SUD compared with ADHD-only patients and suggests the potential role of irritable temperament as a predictor of substance-related problems.

Correlation Between Life Satisfaction and Symptoms of ADHD in Dental Students: The Mediation of Resilience.

This study explores the correlation between life satisfaction and ADHD symptoms. It also discusses whether resilience mediates the correlation between ADHD symptoms and life satisfaction. We surveyed 297 dental students. A total of 291 completed a self-report scale consisting of the Adult ADHD Self-Report Scale, Wender Utah Rating Scale, Life Satisfaction Scale, and Conner-Davidson Resilience Scale. The study used hierarchical linear regression analysis, resampling, and asymptotic strategies for data processing. The ADHD screening results of the self-report scale were positive for 6.87% of the students. This positive rate differed among participants of diverse ages and varying paternal education levels. ADHD symptoms were negatively correlated with life satisfaction and resilience. Life satisfaction was observably positively associated with resilience. Resilience serves as a mediating role between life satisfaction and the two symptoms of ADHD. Resilience intervention programs can enhance the life satisfaction of dental students, especially those with positive ADHD symptoms screening.

Clinical and cognitive characteristics of subjects with schizophrenia and childhood attention-deficit/hyperactivity disorder: Results from the multicentric FACE-SZ cross-sectional dataset

BackgroundChildhood Attention-deficit/hyperactivity disorder (C-ADHD) is a neurodevelopmental disorder, associated with an increased risk of subsequent schizophrenia. The objective of the present study was to determine the prevalence of C-ADHD in schizophrenia and the clinical and cognitive characteristics associated with C-ADHD history in schizophrenia. Methods569 subjects with schizophrenia (74 % men, mean age 30.8) were included in ten expert centers at a national level and tested with a comprehensive battery of clinician-rated, patient-reported scales and cognitive tests. C-ADHD was assessed with the WURS (Wender Utah Rating Scale) self-report questionnaire. Multivariate, correlation, and principal component analyses (PCA) were conducted. ResultsThirty-nine subjects (N = 39, 6.9 %) were classified in the C-ADHD group. Compared to those without C-ADHD, subjects with C-ADHD were more frequently male, had lower education levels, more severe positive clinical symptoms, more subjective cognitive deficits complaints, and lower medication adherence with small to medium effect sizes. Two cognitive components emerged from the PCA, one component including perceptual reasoning and working memory, and another component including visuospatial search and graphomotor speed, cognitive inhibition/flexibility and central executive functioning. Both components were associated with lower performances in the C-ADHD group. ConclusionsC-ADHD is frequent in schizophrenia and associated with more severe positive symptoms and impaired cognitive performances compared to those without C-ADHD. This suggests that the pathophysiological mechanisms contributing to these disorders may lead to the worsening of the cognitive functioning in patients with both disorders. C-ADHD is a relevant clinical marker to discriminate subgroups of schizophrenia with different profiles for a precision-psychiatry approach.

Characterization of cognitive profile in young patients in Buenos Aires, Argentina: preliminary analysis of 5 years and comparing pre‐pandemic and in‐pandemic period

AbstractBackgroundCognitive manifestations are an increasingly frequent reason for consultation among young adults ranging from a subjective cognitive complaint (CC), mood or behavioral disorders to attention disorders or other cognitive functions with an impact on their functionality. The objective of this work is to analyze the cognitive profile of patients evaluated during last 5 years, characterize them and compare the results before the COVID‐19 pandemic and after.Method742 cognitive evaluations were analyzed from a database of patients between 40 and 60 years old who consulted for CC and were evaluated with a standard neurocognitive battery (SNB) between July 2017 and July 2022. Demographic data, screening test (MMSE or MoCA), Beck Depression Inventory (BDI‐2) and/or Hospital Depression and Anxiety Scale (HAD), Wender Utah Rating Scale (WURS) and final assessment diagnosis including criteria for cognitive disorders and depression according to DSM V were performed. Period from 2017 to 2019 was considered pre‐pandemic COVID‐19 period and period from 2020 to 2022 as pandemic period.Result65.6% were female. Pre‐pandemic, 441 patients were evaluated and 296 during pandemic. The average MMSE/MOCA score was: MMSE (328 total): 26.8 and MOCA (402 total): 24.4. Percentage of normal SNB was 17%, of “cognitive deficit”, without conforming deterioration was 36.8%, mild cognitive disorder (mCD) was 43.4%, mayor cognitive disorder (MCD) greater than 2.6%. Of all the patients, depression diagnosis by Beck/ HAD or DSM V was 59.3%. In addition, 25% of the patients had history of TDAH (Attention deficit disorder and hyperactivity) according to WURS. Only 2 patients were evaluated for Intellectual Disability.ConclusionIn this preliminary work, we detected that a high percentage of young patients with CC present some alteration in their cognitive function and almost 60% meet criteria for depression that could impact in these functions. In addition, 25% of patients had a history of TDAH. No significant difference was found between pre and pandemic. We are expanding the sample to be able to characterize the alterations with more specificity.

Could psychostimulant drug use among university students be related to ADHD symptoms? A preliminary study

We aimed to explore if psychostimulant use among student could be linked to attention deficit-hyperactivity disorder (ADHD) symptoms using a self-administered questionnaire sent by email to French students in 2021. Participants were asked about their psychostimulant use and the presence of ADHD symptoms using the Wender Utah Rating Scale and the Adult Self-Report Scale. Among the 4431 respondents, the prevalence of psychostimulant use was concerning and significantly associated with ADHD symptoms. This association could be related to undiagnosed ADHD or to psychobehavioral impairments induced by psychostimulant use underlining the need of ADHD screening and targeted prevention measures.

Toward an Increased Attention on ADHD Symptoms and Traits in Young Adults: Prevalence Data From Screening Tools in a Psychiatric Outpatient Clinic.

to analyze the prevalence of ADHD symptoms and traits in a heterogeneous clinical psychiatric sample of young adults (aged 18-24 years old), who referred to a specialized outpatient clinic for various psychiatric and psychological disturbances. 259 participants completed three validated self-report screening questionnaires for ADHD: the Wender Utah Rating Scale (WURS), the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5 (ASRS-5), and the Conners' adult ADHD rating scale (CAARS). 12.4% of our sample scored above the cut-off at both the WURS and the ASRS-5 and was considered at risk of ADHD. the prevalence rate in our sample is higher than the one found in the adult general population (6.76%), and in the lower range of the one found in the adult clinical population (6.9%-38.8%). The potential role of sociodemographic (age, sex, gender identity, and employment) and comorbidity factors is discussed.

A - 124 The Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) on Cognition and Function in Post-9/11 Veterans with Post-Traumatic Stress Disorder (PTSD).

The study examines the impact of ADHD on cognitive and functional abilities in post-9/11 Veterans with PTSD. 313 Veterans from the Translational Research Center for TBI and Stress Disorders at VA Boston with PTSD only (44.73%), with ADHD only (3.51%), with both PTSD+ADHD (8.63%), and without either condition (43.13%) were evaluated. PTSD was assessed by the Clinician-Administered PTSD Scale (CAPS-IV). ADHD was assessed by the Wender Utah Rating Scale for ADHD (WURS ≥46). WHO Assessment Schedule (WHODAS) measured general functioning. Linear regression models analyzed differences in neuropsychological (Digit Span, Stroop, FAS, Trails, Coding, California Verbal Learning Test, and the Brief Visuospatial Memory Test) and general functioning among the four groups. Veterans with PTSD only performed significantly worse than all other groups on Stroop-Color Naming (β= -0.77, p = 0.022), and FAS-Category Fluency (β= -1.10, p = 0.014). Veterans with both ADHD+PTSD performed significantly slower than all other groups on Trails-Number Sequencing (β= -1.65, p = 0.003). Veterans with PTSD only and with PTSD+ADHD reported significantly worse functional status (β's = 13.56-24.74, p's < 0.0001), mood (β's = 7.87-17.30, p's < 0.0001), sleep quality (β's = 5.06-6.73, p's < 0.0001), and neurobehavioral symptoms (β's = 16.37-25.36, p's < 0.0001) compared to other groups. These findings suggest that PTSD has a larger impact on cognitive performance, specifically processing speed, and functioning than ADHD alone. However, when combined, ADHD compounds the effects of PTSD, resulting in worse functioning across multiple domains compared to Veterans who have only ADHD or PTSD.

Attention-deficit hyperactivity disorder in Egyptian medical students and how it relates to their academic performance.

The neurobehavioral disorder, known as attention-deficit hyperactivity disorder (ADHD), is characterized by impulsivity, hyperactivity, and a lack of focus. In addition, it is connected to poor academic performance. The purpose of this study was to determine the prevalence of ADHD and its effect on their academic performance among medical students. This web-based cross-sectional study was conducted among medical students of four medical colleges during December 2021 and April 2022. Data was collected using a self-administered questionnaire comprising Wender Utah Rating Scale and adult ADHD Self-Report Scale [ASRS]. The link to Google Form survey was distributed to students through academic emails and WhatsApp. Data analyzed using SPSS; Chisquare test or Fisher's exact test as appropriate, were used to determine statistical significance. A total of 990 students filled online questionnaire; 54.7% were females.. The estimated prevalence of ADHD in Egyptian medical students was 11%. Students who had childhood ADHD were significantly linked with the present ADHD (r = 0.54, P < 0.001). There was a negative correlation between the ASRS score for ADHD and students' GPA (r = 0.2, P < 0.001). No statistically significant association was observed between ADHD and sex, type of university, and academic level. of the students. ADHD is prevalent among medical students. Since most of our students with adult ADHD also had preexisting childhood ADHD, it is crucial that the primary care services, especially school health services, have appropriate standards for the early identification and management of ADHD. Health authorities should conduct a comprehensive health education campaign to raise public awareness of ADHD and its risk factors, the clinical picture, and the burden.

Delayed Mid-Sleep Time Associated With Weight Gain While Controlling for Eating Behaviors and Attention Deficit Hyperactivity Disorder Symptoms During the COVID-19 Pandemic.

Society's sleep-wake cycle and eating behaviors have altered and are considered the psychological outcomes of the coronavirus disease-2019 (COVID-19) pandemic. Our aim was to examine the relationship between sleep-wake rhythms, eating behaviors (dieting, oral control, and bulimic behaviors), and attention deficit hyperactivity disorder (ADHD) symptoms with weight gain during the COVID-19 pandemic. The participants were 578 female university students divided into three groups based on weight change during COVID-19 who lost weight, whose weight did not change (nWC), and who gained weight (WG). The participants' information about weight change in the last year and responses to the Pittsburg Sleep Quality Index, Eating Attitudes Test, Adult ADHD Severity Rating Scale, and Wender Utah Rating Scale were collected via an online survey from January 8, 2021 to January 11, 2021. The sleep-wake phase was more delayed in WGs than in the other two groups. The bulimic behavior score was higher and the oral control behavior score was lower in the WG group than in the nWC group. A hierarchical regression analysis model, in which weight change scores were dependent variables, showed that mid-sleep time in second step (β=4.71, t=2.18, p=0.03), and oral control (β=-0.11, t=-3.24, p=0.001)/bulimic behaviors (β=0.20, t=3.20, p=0.001) in third step were associated with weight change after controlling for both current and childhood ADHD symptoms. Chronotherapeutic approaches that regulate sleep-wake rhythm may facilitate weight control of individuals during stressful periods, such as the COVID-19 outbreak.

Is co-occurrence of adult adhd with bipolar disorder a risk factor for violent behavior?

Research has shown that individuals with psychiatric disorders such as bipolar disorder (BD) and attention deficit and hyperactivity disorder (ADHD) have a higher likelihood of violent behavior. This study investigated the frequency of comorbid BD and ADHD in adultpatients and the relationship between this comorbidity and violent behavior. We assessed 105 remitted patients diagnosed with BD I (n = 91) or BD II (n = 14). The patients were administered the Sociodemographic Data Scale, the Wender-Utah Rating Scale (WURS), the Adult ADHD Self-Report Scale (ASRS), the Buss-Perry Aggression Questionnaire (BPAQ), and theViolence Tendency Scale (VTS) as self-reports. The same clinician administered the Diagnostic Interview for ADHD in adults (DIVA 2.0) to patients who scored≥36 on the WURS. Comorbid ADHD was diagnosed in 15.2% of patients according to the DIVA 2.0. In the multiple linear regression analysis, there was a statistically significant positive effect of the ASRS total score on the VTS and the BPAQ total score. Furthermore, it was found that male gender had a statistically significant positive effect on VTS total score and young age had a statistically significant positive effect on BPQA total score. These findings demonstrate an association between BD, comorbid ADHD, and violent behavior.

Predictors of probable attention deficit hyperactivity disorder in elderly patients with mild cognitive impairment visiting a memory clinic.

Characteristics of attention deficit hyperactivity disorder (ADHD) that persist into old age are often confused with symptoms of mild cognitive impairment (MCI), and the actual rate of probable ADHD in people with MCI is unknown. This study estimated the proportion of MCI patients with probable ADHD and investigated the factors to identify MCI patients with probable ADHD. We recruited 36 elderly patients (11 males, 25 females, mean age 72.4 ± 7.6 years) who met the MCI criteria. The MCI patients were classified as those with [MCI/ADHD (+)] and without [MCI/ADHD (-)] probable ADHD, according to the Wender Utah Rating Scale scores. The autism features, inattention, and hyperactivity features during childhood and current periods, estimated intelligence quotient, and demographic data were compared between the groups. Multiple logistic regression analysis was performed to identify factors of MCI/ADHD (+) patients. Nine (25.0%) and 27 patients were added into the MCI/ADHD (+) and MCI/ADHD (-) groups, respectively. The MCI/ADHD (+) group mostly comprised men, those who visited the clinic at a younger age, had more years of schooling, and had strong autism spectrum disorder tendencies. Multiple logistic regression analysis indicated male sex and current hyperactivity as significant predictors of probable ADHD in MCI patients. A quarter of the patients with MCI had probable ADHD. Male sex and hyperactivity at the time of MCI diagnosis might help in predicting probable ADHD in MCI patients. However, these results were obtained from a single-center, small-case study and should be confirmed via longitudinal studies with a large number of cases.

Frequency of and Factors Associated with the Presence of a History of Probable Attention-Deficit Hyperactivity Disorder in a Population of Patients with Sex Addiction

Introduction: Since the first description of sex addiction (SA) by Carnes, research on this problematic behaviour has continued to grow, and the association with attention-deficit hyperactivity disorder (ADHD) appears to be frequent. This study aimed to estimate the frequency of a history of probable ADHD in a population of patients with SA and to explore the factors associated with it. Methods: One hundred 85 patients referred to the Nantes University Hospital for SA between 2011 and 2020 were included. Patients completed the Sexual Addiction Screening Test (SAST) or its revised version (SAST-R) to establish the presence of SA. As the SAST-R was not validated in French, we conducted a validation study for the French version. ADHD was screened using the Wender-Utah Rating Scale in childhood and the Adult ADHD Self-Report Scale in adulthood. A multivariate logistic regression model was used to identify factors associated with the presence of a history of probable ADHD. Results: Childhood ADHD was identified in 36% of patients with SA. Factors associated with the presence of a history of probable ADHD were a low education level, an earlier age of onset of problematic sexual behaviour, another addictive disorder, an anxiety disorder, impulsivity (high negative urgency score), and high scores on harm avoidance and novelty-seeking temperament scales. Furthermore, the French version of the SAST-R displayed good psychometric properties, especially excellent sensitivity. Conclusion: The frequency of a history of probable ADHD among patients with SA is consistent with the literature and close to the highest range. Specific personality traits in patients with both SA and a history of probable ADHD could induce lasting problems of adaptation, which may precipitate the development of SA or maintain it.

Functional Near-Infrared Spectroscopy Evidence of Prefrontal Regulation of Cognitive Flexibility in Adults With ADHD

Background: Executive function (EF) deficit is considered to be a core cognitive deficit in ADHD. The current study combined functional near-infrared spectroscopy (fNIRS) and numerical switching tasks to investigate the cognitive flexibility of adult ADHD as an important part of EF. Material and Methods: The Wender Utah Rating Scale and the adult ADHD self-rating scale were respectively used to assess ADHD symptoms in childhood and adulthood. A 22 adults with ADHD and 24 healthy controls (HCs) participated in the large/small and odd/even switching tasks. Results: Behavioral results were indicative of the ADHD switch costs being lower than the HCs. The fNIRS results also showed that ADHD’s frontal eye field was over-activated both in magnitude and switched judgment tasks. The dorsolateral prefrontal cortex was also over-activated in magnitude judgment tasks. Conclusion: These results revealed that adults with ADHD’s cognitive flexibility performed better than the HCs, which result is different from mainstream ideas that EF is a core deficit in ADHD.

Heterogeneity of associations between dissociation and attention deficit symptoms.

Childhood trauma and dissociative experiences are suggested to be predisposing transdiagnostic factors for attention deficit /hyperactivity disorder (ADHD) as well as many psychiatric disorders. Trauma-related symptoms such as motor restlessness, emotional instability, and concentration problems can mimic, trigger, or exacerbate ADHD symptoms. Moreover, given the relationship between ADHD and trauma-induced distress, it has been suggested that dissociative experiences and attention problems may reveal overlapping characteristics. The aim of this study was to investigate the associations between dissociative experiences and attention deficits by carrying out mixture analysis. A thousand and thirty-seven participants volunteered to the online investigation. Participants completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale (ASRS), Wender Utah Rating Scale (WURS), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ). Item responses on the DES and attention deficit symptoms as indexed by the ASRS were subjected to latent class analysis. The three-latent-class model outperformed alternative mixture models. Mixture analysis classified the sample into three homogenous subgroups as follows: (1) No/low dissociation or attention problems; (2) Moderate dissociation with attention problems; and (3) High dissociation with attention problems. High dissociators with attention problems were characterized by heightened scores on somatoform dissociation and emotional neglect. No/low dissociation or attention problems latent class reported significantly lower scores on hyperactivity/impulsivity, depression, attention deficit in childhood, and sexual abuse than both moderate and high dissociation latent classes. High dissociators and moderate dissociators significantly differed on conduct problems and physical abuse. We concluded that impulsive hyperactivity, depression, and childhood sexual abuse were common features in heightened dissociation latent classes, as well as attention deficit.

Characteristics of Attention-Deficit/Hyperactivity Disorder Subtypes in Children Classified Using Quantitative Electroencephalography.

This study used quantitative electroencephalography (QEEG) to investigate the characteristics of attention-deficit/hyperactivity disorder (ADHD) subtypes in children. There were 69 subjects (42 with ADHD and 27 neurotypical (NT)) in this study. A semi-structured interview was conducted with each participant for psychiatric diagnostic evaluation. We measured the absolute and relative power in 19 channels and analyzed QEEG using the following frequency ranges: delta (1-4 Hz), theta (4-8 Hz), alpha 1 (8-10 Hz), alpha 2 (10-12 Hz), beta 1 (12-15 Hz), beta 2 (15-20 Hz), beta 3 (20-30 Hz), and gamma (30-45 Hz). Group analyses and EEG noise preprocessing were conducted using iSyncBrain, a cloud-based, artificial intelligence EEG analysis platform. Analysis of covariance adjusted for IQ, age, and sex was used. QEEG analysis revealed three ADHD subtypes, characterized by (A) elevated relative fast alpha and beta power, (B) elevated absolute slow frequency (delta and theta power), or (C) elevated absolute and relative beta power. A significant difference was found in the Korean ADHD Rating Scale (K-ARS) among the four groups (df=3, F=8.004, p<0.001); group C had the highest score (25.31±11.16), followed by group A (21.67±13.18). The score of group B (12.64±7.84) was similar to that of the NT group (11.07±6.12) and did not reach the cut-off point of the K-ARS. In the Wender-Utah Rating Scale (WURS), group B score (55.82±23.17) was significantly higher than the NT group score (42.81±13.26). These results indicate that children with ADHD do not constitute a neurophysiologically homogenous group. Children with QEEG subtype B (elevated slow frequency) may be difficult to distinguish from normal children using the K-ARS, which is the most common screening tool for ADHD. Moreover, parents of children with this subtype may be less sensitive to observing ADHD symptoms.